17-year-old Justin is a high school senior who lives at home with his parents and younger brother. He has never even kissed a girl. He has a crush on Rebecca who believes in environmental causes, and is also a little awkward with him. He is smart but nervous, and he comforts himself by sucking his own thumb. His dentist tries to hypnotize him to solve his problems, but it doesn't work so well, since Justin feels worse when he can't soothe himself. Justin does eventually go on Ritalin, and it works very well for him; he starts to do extremely well at school and flourishes on the debate team. Justin embraces the medication and loves how it affects him. However, eventually it seems that he becomes overconfident and dependent on the medication. He crashes, and starts smoking pot, but he also goes on with his life.

The acting on Thumbsucker is impressive: Lou Taylor Pucci as Justin is great at being insecure and obnoxiously confident. Tilda Swinton as his mother Audrey is mesmerizing on the screen. Keanu Reeves as the dentist is annoying, but then he is meant to be. It is a simple plot, but it is enough to keep you interested. It is one of the few movies to address ADHD and the possibility of over-use of medication as a treatment, and it does so thoughtfully. Justin's relationships with his parents and his brother and his burgeoning relationship with Rebecca are depicted in short bursts and with great subtlety.

In 2000, I reviewed Walter Kirn's novel Thumbsuckerand I was unenthusiastic. I found it smug and the characters were not likable. The movie is much simpler than the novel, and it has a very different feeling to it. Much of this has to do with the haunted look on Lou Pucci's face, and the soundtrack featuring the melancholy and meditative music of the Polyphonic Spree and Elliott Smith. Justin is still rather annoying in the movie, but he is a more appealing character than he was in the book. Director Mike Mills explains in his commentary that he likes to mix up his styles, and he does this, including some surprising moments of almost hallucinogenic events. This breaks up the cohesion of the movie and makes it feel a little unformed. The inclusion of Keanu Reeves' dentist character does not work so well, partly because the fact you can't forget that you are watching Keanu. Yet on the whole the movie has enough going on to make it interesting and appealing.

The DVD has a "making of" short feature, an extended discussion between Mike Mills and Walter Kirn, and a director's commentary. Kirn explains that the novel, which was his first, was basically autobiographical. We get interviews with the actors which are a little over enthusiastic. However, Mills himself is very self-effacing and careful to explain his ideas, and he and Kirn seem to genuinely get on well together. These extras are not particularly illuminating but they do provide some background.

Psychiatrically speaking, Thumbsucker is notable because it deals with attention deficit and medication, and so anyone interested in these themes will find it worth seeing.

Christian Perring, Ph.D., is Associate Professor of Philosophy at Dowling College, Long Island. He is also editor of Metapsychology Online Reviews. His main research is on philosophical issues in medicine, psychiatry and psychology.

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